Downsides of following topics include:
- Questions might be "mislabeled" with topic tags, causing unwanted questions to land in the feed.
- The sheer potential number of questions that can fill up your feed within the busier topics.
Downsides of following questions include:
- You can more easily forget why you cared about a question than a topic over time, especially if the question "heats up" a few days after you added it.
- Often, many similar questions exist, which share a topic. Follow one question, and you can miss out on excellent answers in related or even near-duplicate questions.
Downsides of following people include:
- Lots of them write really great single answers, but become downright scary to observe over time (case in point: Dean Blackburn)
- There appears to be a cap on per-user contributions to your feed, so you can miss great answers/questions/posts by people who over-exert like Yishan Wong.
Overall, the biggest downsides to all of the above options can be boiled down to this: the more items that appear in your feed, the greater a potential time sink Quora can become for you.
So, the answer to your question is: it depends. (yay)
If you have a few well defined interests, following those topics will make you less likely to get annoyed when they clog your feed.
If you find a really great question that you want to know the answer to, following it directly can save you a lot of trouble over following the topic(s) the question falls under. This can be a real "space saver" for the feed, assuming you don't also follow many topics and people.
Certain users – like Marie Stein, Shannon Larson, Jonas M Luster or Mark Hughes to name a few – seem to leave a lot of really great answers, either within a specific set of topics, or like "human-encyclopedic shotguns", peppering their wisdom across the site. Following them specifically can save you a lot of time(*).
In summary, the best method to create a "followed content" feed on Quora varies depending on the user, their own interests and expertise, as well as how much time they want to spend on Quora.
(* As an added bonus, these "Children of the Quorn", as they are often referred to, are also great discovery tools for the rest of us – while we sleep contentedly in our beds, they are wide awake seemingly at all hours… Seeking out new queries, and boldly laying the knowledge on us as if they were on some kind of "five year mission to get as many Marc Bodnick upvotes as possible".)